Antique 1923 Opium Cocaine Federal Narcotic Order Form Pharmacy Doctor History

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Antique 1923 Opium Cocaine Federal Narcotic Order Form Pharmacy Doctor History
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A great original 1923 Treasury Department issued order form for Opium or Coca Leaves, or Compounds, Manufactures, Salts, Derivatives or Preparations! This 1923 issue (the red duplicate) was recently shown on the History Channel during a program on illegal drugs. This is the only issue in which the government printed a lengthy list of "Instructions" on the back. Please see photos!
This form is ornate with a beautiful poppy graphic on the top corner. It was issued to Dr. Herbert S. Martyn, of Cuttingsville, VT, on February 15, 1924. An order for Morphine was placed on August 24, 1925, the top original copy was sent to Norwich Pharmacal Company., in Norwich, NY to be filled.
The form is large, 10 3/4" by 8 1/2", is watermarked, "USIR", has some light bends, two corner bends and light age toning (not pure white), otherwise, condition is excellent!
Pleased to combine shipping with other Prohibition Prescriptions, Liquor Licenses, Opium Forms & Pharmacy Labels. As always, many thanks to my regular customers for your continued patronage! :)
All items ship within 24 hours of payment!
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